A Review of Recent Findings for Obstetricians about Combined Oral Contraceptive Pills

Abstract

Combined oral contraceptive pills (OCPs) contain estrogen (ethinylestradiol) and progesterone (first-generation levonorgestrel and fourthgeneration drospirenone). Progesterone has peripheral effects on the endometrium, fallopian tubes, and cervix and can promote contraception. These pills are used to prevent pain caused by Mittelschmerz syndrome and endometriosis and to treat hyperandrogenism. To prescribe contraceptives, it is adequate to take the patient's medical history and blood pressure. In the absence of risk factors, patients should be followed-up by history-taking, blood pressure measurement, urinalysis, Pap smear test, and examination of breasts, pelvis, and liver. The risk of venous thrombosis in new OCPs is twice higher than that of older generations and usually occurs in the first year of consumption. The only absolute contraindications for the use of new OCPs include chronic and acute cholestatic liver diseases. In fact, use of new OCPs increases the risk of liver adenoma, but not hepatocellular carcinoma. On the other hand, in female patients with genital tract cancers, risk of endometrial and ovarian epithelial cancers decreases following the use of OCPs. However, the risk of cervical adenocarcinoma increases after 5 years of consumption due to cervical eversion and impaired vitamin metabolism. These pills are contraindicated in women above 35 years who smoke more than 15 cigarettes daily or have uncontrolled hypertension, venous thromboembolism, migraine aura, severe hyperglycemia, breast cancer (diagnosed or suspected), or diabetes mellitus associated with cardiovascular diseases.

Investigation of Antioxidant, Antifungal, Antibacterial, and Anti-inflammatory Effects of Teucrium polium on Common Pathogens in Vaginitis: A Review

“…Vaginitis is a general term for vaginal disorders caused by infection, inflammation, or changes in the normal flora of the vagina. It is one of the women's most common causes of referring to physicians (1). Vaginitis can occur at any age and affect almost any woman at some point in her life.…”

“…Given the persistent symptoms of this vaginitis, drugs such as metronidazole, tinidazole, and secnidazole are used to treat it. This vaginitis is highly associated with sexually transmitted diseases (STDs) (1,9).…”

New Management of Gestational trophoblastic diseases; A Continuum of Moles to Choriocarcinoma: A Review Article

“…In choriocarcinoma without villous formation, syncytiotrophoblast proliferation and necrosis with bleeding would be seen. The risk factors of this aberrant fertilization have not been fully understood but the most common are [2] : 1) Extreme of reproductive age (Risk Ratio 1-5) 2) History of prior molar pregnancy (Risk Ratio 10-40) 3) Only consistent environmental association between Beta-carotene and dietary animal fat intake 4) Oral Contraceptive pill and previous abortion are risk factors for partial mole. 5) Choriocarcinoma risk factor is, prior complete mole, ethnicity and advanced maternal age The aim of the present study was to review the new management of gestational trophoblastic diseases.…”